Author: Andrew Harrop

Age UK’s new report ‘Care in Crisis: causes and solutions’ opens six weeks of intense debate as we run-up to the publication of the Dilnot Report on the funding of care and support. The main purpose of our paper is to explain how and why older people’s care has reached financial breaking point. By re-analysing existing data from official and academic sources we have assembled a devastating critique of the care system for older people as it stands today.

High and rising levels of unmet need are the first signs that the system is failing. Already, out of 2 million older people in England with care-related needs, 800,000 receive no formal support from public or private sector agencies. As a result of spending cuts, combined with rising need, the figure is likely to pass one million between 2012 and 2014. Continue reading “Countdown to the Dilnot Report – Care in Crisis”

It was striking that the conversation was dominated by healthcare. We distinguished between ‘true’ age-related healthcare costs, associated with chronic conditions and long term care, as opposed to the costs of the last year of life, which arise whenever someone dies and may actually be higher for early death (when people are more likely to benefit from costly interventions).

There was agreement that ageing is not the main driver of health costs, with improving technology and rising expectations considerably more important.

Participants questioned whether US health spending was an unusual outlier, or the inevitable trajectory for other advanced economies. While American delegates tended to be fatalistic about health costs, participants from other countries pointed to their success in checking rising costs and maintaining health spending at a lower share of GDP (usually with better health outcomes, since healthcare only has a small impact on a society’s health). Continue reading “Impacts of ageing for developed economies”

I recently spent three days at a conference on ageing in developed economies, hosted by the Ditchley Foundation at their splendid Oxfordshire pile. I was one of the rapporteurs for the event and asked to focus on the causes and impacts of population ageing.

Undaunted by the breadth of this exam question participants from Sweden, the UK, Canada, the US, Japan and the Netherlands pooled their evidence and insight to considerable effect. In this first blog, I précis our discussions on causes and trends (NB the whole conference was under the Chatham House rule).

Image from enabledbydesign via Creative Commons

Fertility – There was surprisingly little discussion of the impact of the post-1945 baby boomers (perhaps experts now take them for granted, or see them as only transitory phenomenon). By contrast there was intense debate on the subsequent slump in fertility observed since the 1960s across the developed world.

Fertility rates vary widely, with the USA and Scandinavia remaining fairly fertile, while Southern Europe and East Asia have seen fertility fall far below population replacement requirements. The latter will lead to population decline and for coming decades skew the age profile of the population upwards, for as long as older, more fertile generations remain alive.

Interestingly the UK, Germany and France seem to have had some success in improving fertility in recent years. There was scepticism about the effectiveness of deliberate pro-birth incentives but agreement that flexible work and supported childcare is very important (migrant mothers play a moderate role too).

However I was surprised to hear that the strongest determinant of variations in developed world fertility rates are our different attitudes to birth outside marriage. This lesson implies that conservative cultures may find it very difficult to increase fertility (it also adds a new dimension to the UK debate on using public policy to support marriage). Continue reading “Trends in ageing for developed economies”

The highlight today for Age UK was the hint that the Government will introduce a simple flat-rate state pension of around £140 a week. This will be great news for those who receive it – we’ve been calling for a simpler, better single State Pension for many years. But as always, the devil is in the detail. We didn’t hear today when this pension is going to be implemented, and we know from the Chancellor’s statement that it won’t apply to those currently in receipt of State Pension. With 1.8 million older people living in poverty in the UK today, we believe that more needs to be done to tackle pensioner poverty now.

Future increases to the State Pension Age past 66 will now to be determined by an automatic process, according to today’s Budget statement. While we accept that the State Pension Age will have to increase periodically to take account of welcome increases in life expectancy, simplistic indexation is not the answer. In particular, it’s essential that any increase isn’t based solely on average life expectancy, as health inequalities mean that life expectancy varies wildly across the UK. Any new uprating must also take into account the impact changes will have on the poorest, those out of work and those with health problems or disabilities.

After spending years campaigning for an end to age discrimination, it was disheartening today to see the postponement of new age equality provisions for small businesses. We’ve been promised that this will not include the ending of the Default Retirement Age, which will begin to be phased out from April, but it will water down the banning of age discrimination in the provision of goods and services. Age equality makes economic sense, and older consumers’ spending will be key in reducing the deficit, so we would have liked to see more Government support to help small businesses adapt to the changes, rather than abandoning them.

Finally, there were areas where the Budget said nothing, where action was urgently needed. We already know that adult social care is going to be badly hit from April, as we hear news of local government cuts. We asked the Chancellor to channel any extra money he could find to top up support for care users who are among the most dependent in society. Yet while there was a little extra for other favoured projects – money for councils to fill potholes among them – there was nothing to see off the looming crisis in care.

In the second post previewing Agenda for Later Life 2011 we look back a year to the priorities we highlighted in the 2010 edition of the report. Published just weeks before the general election, we knew in March 2010 that a lot would change over the coming year, but no one predicted how much. The political landscape has of course transformed, but there have been huge ruptures in public policy on later life as well. The 2011 report charts the changes impacting us as we all live through or look forward to our later years.

There are many positives to report. It was a year of considerable progress on issues that Age UK and our predecessors have campaigned on for many years. In early 2010 we published our pre-election manifesto, Our Power Is Our Number, setting out 30 challenges to the political parties. We were delighted when key proposals appeared in the manifestos of all three main parties, and then in the subsequent coalition agreement.

In the list below we evaluate progress on each of our election priorities with a traffic-light score. Some (labelled red) have been ignored by the new administration; notably our proposals for specialist support packages for unemployed over-50s, the future-proofing of new housing and prioritising older people within international development and disaster relief. In health there are radical proposals for reform, but it is far from clear how these will affect the priority issues that we highlighted last year, with respect to dignity and mental health. Continue reading “Agenda for Later Life report – last year’s priorities”

The programme for tomorrow’s Agenda for Later Life conference is looking fantastic. Both our keynote speakers, Iain Duncan Smith and Andrew Dilnot, are set to break new ground with their plenary speeches. The Secretary of State for Work and Pensions will give his first major speech on ageing, in what promises to be an important statement of government policy. Meanwhile Andrew Dilnot will be making a major public intervention as Chair of the Commission on Funding of Care and Support, setting out his preliminary conclusions at the commission’s half-way point (as I blogged last week)

Earlier, there’ll be a new look for the morning session, with three parallel conferences on poverty, older consumers, and the integration of health and care. I’ll be chairing the session on integration, holding court between two Jo’s of the health world – Webber, of the NHS Confederation, and Williams, of CQC. Baroness Sally Greengross and Gavin Poole of the Centre for Social Justice headline the other two sessions. Before that the conference, chaired this year by broadcaster John Stapleton, opens with a panel debate on changing attitudes to ageing, with the speakers including gay rights campaigner Ben Summerskill, who’ll draw lessons from the huge strides made in challenging homophobia over recent years.

With breakout discussion seminars sandwiched between the main sessions, this year’s Agenda for Later Life offers up an incredible depth and range of expertise. Only a conference on ageing could bring together senior speakers from such a huge and respected list of companies, public bodies and charities: Care and Repair England, the Care Quality Commission, Cisco Systems, City of London Police, the Equality and Human Rights Commission, the Federation of Small Business, Foundations, the International Longevity Centre UK, the Local Government Information Unit, NCVO, the NHS Confederation, the Pensions Policy Institute, Sainsbury’s, Stonewall, Which? and the Yorkshire Building Society.

We’ve been running conferences like this since 2004. Without a doubt the 2011 edition – with thanks to Sainsbury’s generous sponsorship – breaks new ground, both in the depth and breadth of our contributors, and in creating the space to think aloud for two keynote speakers who really are setting the agenda for later life.

In our latest post on highlights from the Agenda for Later Life 2011 report we reflect on the three key governing principles of the coalition government so far: deficit reduction; localism and the ‘Big Society’; and radical structural reform.

From the day that the Coalition Agreement was published in May 2010, it became evident that the new administration would be founded on a set of strong governing principles. The Government’s overriding priority has been its total commitment to eradicating the budget deficit within five years. The Spending Review was a mixed bag for people in later life. The headlines were mainly positive, particular with respect to spending areas most directly associated with later life, with protection for the NHS and key age-specific entitlements.

But behind the scenes, it was clear that everyone in later life would be hit hard as the heaviest users of public services in general. In particular, local government in England faces a transformation, as it loses 26 per cent of its central government grant over the period 2011/12 to 2014/15, with poorer areas the worst affected. As councils have announced their budgets in recent months, it has become clear that vital services for later life will be hit hard. There are also concerning changes to social security benefits, including cuts to Local Housing Allowance, Council Tax Benefit and Employment Support Allowance (paid to people in their 50s and early 60s).

A hugely significant long-term change was the surprise decision to switch social security uprating from the Retail Price Index to the Consumer Price Index, which almost always increases at a lower rate since it excludes housing. While this will not affect the basic State Pension or Pension Credit Guarantee, all other benefits, as well as many occupational pensions will now be lower in the future. For example, if CPI remains around 0.9 per cent lower than RPI over time, the Pension Policy Institute calculates that by the time a 65-year-old with a public-sector occupational pension reaches 85, he or she can expect to be receiving 8 per cent less income, from all sources, than if today’s system were preserved.

The second major theme of the Government is its commitment to the overlapping concepts of ‘localism’ and ‘the Big Society’. Although these terms are much debated, the Government’s agenda breaks down roughly into four dimensions:

a continuation of Tony Blair’s commitment to opening up public services to independent providers, but with an increased emphasis on the potential of non-profit and employee-owned operators

accelerated devolution of power from Whitehall and the English regions to local level

a commitment to giving citizens more say over public decisions, and the ability to run services and amenities if they wish

a desire to see a surge in autonomous community activity, charitable delivery and philanthropy.

So far the most concrete manifestation of these principles have been the Localism Bill and the removal of almost all ring-fencing from local government funding. However, localism and Big Society should be thought of as principles that inform all policy thinking, rather than a specific list of activities.

Many of the Government’s intentions are laudable, although it remains to be seen whether the strategy that ministers are adopting really can succeed in influencing deep-seated social behaviours or in changing the institutional norms of the public sector. But the flurry of enthusiasm and piecemeal initiatives may be sidestepping the need for a fundamental debate about the role of the state. The philosophy of the Big Society is that government should enable communities to solve problems for themselves, rather than impose answers. The lines of responsibility between the state and communities are deliberately intended to be fuzzy; and diversity, and indeed failure, is seen as a strength rather than a weakness. This is a fundamental challenge to the traditional statist view, which sees central government as a provider of enforceable entitlements, a guarantor of consistent minimum protection and the main driver of innovation and strategic change. Continue reading “Agenda for Later Life report – 3 coalition principles”